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81. Nonpharmacological Management of Procedure-Related Pain in the Breastfeeding Infant

procedures without mother available for direct breastfeeding and when expressed human milk is not available to use as a supplement, use of sucrose and sucking may be considered (IA). 1. Sucroseandpaci?er. The combination of oral sucrose and paci?er or non-nutritive sucking is remarkably soothing. 34 This technique offers consistent pain reduction to infants undergoing heel lance, venipuncture, and intramuscular injection. Evidence for pain reduction in procedures such as arterial puncture, subcutaneous (...) injection, insertion of nasogastric or orogastric tubes, bladder catheterization, and eye examinations is less conclusive though most trials demonstrate at least some bene?t of sucrose use. 1,31,35 Because pain reduction achieved when using both sucrose and non-nutritive sucking is similar to that with breast- feeding, using a paci?er dipped in 24% sucrose (by weight) solution whenever breastfeeding is not pos- sible is an effective option (IB). 36,37 Sucrose admin- istration should begin 2 minutes

2016 Academy of Breastfeeding Medicine

82. Breastfeeding Promotion in the Prenatal Setting

forthecareofbreastfeedingmothersandinfantsanddonotdelineateanexclusivecourseoftreatmentorserve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Background B reastfeeding provides ideal infant nutrition and is physiologic for mothers and children. 1–4 Pregnant women often make a decision regarding breastfeeding early in preg- nancy, and many have already decided whether to breastfeed prior to conception. 5–7 Encouragement and education from healthcare providers result in increased breastfeeding initia- tion (...) patient services and support (e.g., local, regional, and national maternal– child organizations, local La Leche League International groups, community health workers, health departments, local or regional maternity hospitals or birth centers, not-for-pro?t organi- zations, breastfeeding peer counseling programs; supplemental food programs [such as the Special Supplemental Nutrition Program for Women, Infant and Children in the United States], and home visiting programs). Departments of 1 General

2015 Academy of Breastfeeding Medicine

83. Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates

breastfeeding meets the nutritional and metabolic needs of healthy, term newborn infants. Healthy term infants do not develop clinically signi?cant hypoglycemia simply as a result of time-limited underfeed- ing. 18,19,21 (III) 1. Healthy, appropriate weight for gestational age, term infants should initiate breastfeeding within 30–60 minutesoflifeandcontinuebreastfeedingoncue,with Table 3. At-Risk Infants for Whom Routine Monitoring of Blood Glucose Is Indicated Small for gestational age: 90 th percentile (...) immediately in infants with clinical signs. Table 5 summarizes these recommendations. Management of Documented Hypoglycemia (Table 6) A. Infant with no clinical signs (absence of clinical signscanonlybedeterminedbycarefulclinicalreview) 1. Continue breastfeeding (approximately every 1–2 hours) or feed 1–3mL/kg (up to 5mL/kg) 18 of ex- pressed breastmilk or substitute nutrition (pasteurized donor human milk, elemental formulas, partially hy- drolyzed formulas, or routine formulas). Glucose wa- ter

2014 Academy of Breastfeeding Medicine

84. Guidelines for Breastfeeding Infants with Cleft Lip, Cleft Palate, or Cleft Lip and Palate

, 15 but otherswithlargercleftsofthesoftand/orhardpalatemaynot generate suction. 15,16 Newborns and premature babies gen- erate lower suction pressures compared with older ba- bies. 13,17,18 Babies with CP or CLP have dif?culty creating suction 19 because the oral cavity cannot be adequately sepa- rated from the nasal cavity during feeding. For these infants, negative consequences may include fatigue during breast- feeding, prolonged feeding times, and impaired growth and nutrition. 1 Speech (...) , revised 2009.’’ 28 ) Infants with CL/P may require supplemental feeds for adequate growth and nutrition. 24 (III) There is one study that demonstrated that additional maternal support by a clinical nurse specialist can both improve weight gain outcomes and also facilitate referral to ap- propriate services. 29 (III) 7. Modi?cation to breastfeeding positions may increase the ef?ciency and effectiveness of breastfeeding. Posi- tioningrecommendationsthathavebeenrecommended on the basis of weak evidence

2013 Academy of Breastfeeding Medicine

86. Breastfeeding an Infant or Young Child with Insulin-Dependent Diabetes

the amount of carbohydrate for expressed breast milk 3. Insulin dosing in infants who have the style of small volume, frequent feeds 4. Goals and methods for glycemic control in breast- feeding infants and young children with diabetes 5. Guidanceoncounselingparentsofbreastfeedinginfants and young children with diabetes, addressing the guilt associated with poor glycemic control and providing support to continue breastfeeding after diagnosis Background Breastfeeding provides ideal infant nutrition (...) tomake healthy food choiceslaterinlifeislikelytoaidinachievingbetterglycemic controlinadolescentsandadultswithdiabetes. Summary of the Recommendations 1. Breastfeeding is the optimal form of infant nutrition for infants and it should be promoted as such by healthcare providers for infants with diabetes. 2. When calculation of carbohydrate intake is utilized for insulin dosing, a carbohydrate count of 70g/L can be used for breast milk. (IA) (Quality of evidence [levels of evidence IA, IB, IIA, IIB

2017 Academy of Breastfeeding Medicine

87. WHO Guidelines on Integrated Care for Older People (ICOPE)

for Nutrition and Health, Cambridge, United Kingdom); Sumantra Ray (Medical Research Council, Cambridge, United Kingdom); Richard Uwakwe (Nnamdi Azikiwe University, Awka, Nigeria). The department would like to thank the ICOPE guidelines steering group: Said Arnaout (WHO Regional Office for the Eastern Mediterranean); Anjana Bhushan (WHO Regional Office for the Western Pacific); Alessandro Rhyl Demaio (WHO Department of Nutrition for Health and Development); Shelly Chadha (WHO Department for Management (...) Pablo Peña-Rosas (WHO Department of Nutrition for Health and Development); Anne Margriet Pot (WHO Department of Ageing and Life Course); Ritu Sadana (WHO Department of Ageing and Life Course); Céline Yvette Seignon Kandissounon (WHO Regional Office for Africa); Maria Pura Solon (WHO Department of Nutrition for Health and Development); Mark Humphrey Van Ommeren (WHO Department of Mental Health and Substance Abuse); Enrique Vega Garcia (WHO Regional Office for the Americas); Temo Waqanivalu (WHO

2017 World Health Organisation Guidelines

88. Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups

and women of reproductive age 59 C. Preventive chemotherapy in pregnant women 60 ANNEX 3. LOGIC MODEL FOR THE CONTROL OF SOIL-TRANSMITTED HELMINTH INFECTIONS 61 ANNEX 4. WHO STEERING GROUP 62 ANNEX 5. WHO GUIDELINE DEVELOPMENT GROUPS 63 Guideline development group – nutrition actions 2013–2014 63 Guideline development group – deworming 67 ANNEX 6. EXTERNAL RESOURCE GROUPS 70 Meeting of the WHO guideline development group – nutrition actions 2013–2014 70 Meeting of the WHO guideline development group (...) for guideline development were followed. This document presents the evidence that served to inform the recommendations contained herein, and provides expanded sections on dissemination as well as on ethical and equity considerations, summarized in the most recent reviews on these topics. ACKNOWLEDGEMENTS This guideline was coordinated by WHO’s Evidence and Programme Guidance unit, Department of Nutrition for Health and Development and the Preventive Chemotherapy and Transmission Control unit, Department

2017 World Health Organisation Guidelines

89. Assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition

obesity, cardiovascular disease or diabetes mellitus type 2 in later life: a systematic review 49 b. Nutritional assessment and growth monitoring in IMCI countries: a survey of IMCI chart booklets and clinical algorithms used in different countries, reporting current uptake and adaptations of IMCI at national level 49 c. Benefits and harms of supplementary foods in moderately and severely undernourished infants and children (6–59 months) 49v Annex 3. Systematic reviews of interventions to prevent (...) -for-age, weight-for-length/height, body mass index (BMI)-for-age, or mid-up- per arm circumference. The nutritional status of children is classified based on the anthropometric measures in the Table 1 below. Table 1. World Health Organization (WHO) classification of nutritional status of infants and children Nutritional status Age: birth to 5 years Indicator and cut-off value compared to the median of the WHO child growth standards a Obese Weight-for-length/height b or BMI-for-age >3 standard

2017 World Health Organisation Guidelines

90. Faltering growth: recognition and management of faltering growth in children

and children, which is often related to nutritional intake. 1.1.1 Be aware that: it is common for infants to lose some weight during the early days of life this weight loss usually stops after about 3 or 4 days of life most infants have returned to their birth weight by 3 weeks of age. 1.1.2 If infants in the early days of life lose more than 10% of their birth weight: perform a clinical assessment, looking for evidence of dehydration, or of an illness or disorder that might account for the weight loss (...) of an oral liquid nutritional supplement for infants or children with continuing faltering growth despite other interventions (see recommendations 1.2.16 to 1.2.22). 1.2.24 Regularly reassess infants and children receiving an oral nutritional supplement for faltering growth to decide if it should be continued. T ake into account: weight change Faltering growth: recognition and management of faltering growth in children (NG75) © NICE 2019. All rights reserved. Subject to Notice of rights (https

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

92. Prevention of Peri-operative Venous Thromboembolism in Paedatric Patients

in approximately 10% Drugs Chemotherapy e.g. aspariginase Contraceptive pill (3 fold increase risk) Parenteral nutrition (may be line related) Immobility 25% cases with prolonged bed rest Pregnancy (2) 2 fold increase Congenital thrombophilia (3/4) Factor V Leiden Antithrombin III deficiency Protein C / S deficiency Increased F VIII Acquired Thrombophilia (3/4) Nephrotic syndrome Antiphospholipid syndrome Connective tissue disease Obesity (2) Increased incidence of VTE cardiac disease Congenital disease

2017 Association of Paediatric Anaesthetists of Great Britain and Ireland

93. Guidelines on autopsy practice: Third trimester antepartum and intrapartum stillbirth

· provide information for audit purposes (e.g. antenatal diagnosis, pregnancy and intrapartum care) · provide information for national clinical outcome review programmes. 3 Pathology commonly encountered at autopsy · Hypoxia · Growth restriction: symmetric, asymmetric (nutritional) · Infection · Congenital malformation · Trauma: cranial, extracranial · Blood loss · Hydrops fetalis · Fetal conditions secondary to maternal disease e.g. diabetes, hypertension and pre-eclampsia · Placental and umbilical (...) , including: nutritional status/soft tissue and muscle bulk, maceration, local/generalised oedema, pallor, meconium staining, dysmorphic features, evidence of trauma (intrapartum death) and other iatrogenic lesions, assessment of CEff 150617 7 V1 Draft patency of orifices (including choanae) and palatal fusion, limbs, hands and feet and genitalia · Longitudinal skin incision on front of body (typically T- or Y-shaped); measurement of fat thickness over sternum (if appropriate) · Central nervous system

2017 Royal College of Pathologists

94. Guidelines on autopsy practice: Fetal autopsy (2nd trimester fetal loss and termination of pregnancy for congenital anomaly)

restriction: symmetric, asymmetric (nutritional) · Viral/protozoal infection (CMV, Parvovirus, toxoplasmosis, other) · Congenital malformation (all systems) · Hydrops fetalis · Fetal akinesia sequence · Placental and umbilical cord disease · Changes in the baby and placenta secondary to intrauterine death. The above is not an exhaustive list and users are referred to the relevant textbooks. 4 Specific health and safety aspects The pathologist needs to know the results of the antenatal infection screens

2017 Royal College of Pathologists

96. Guidelines on the management of abnormal liver blood tests

/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal (...) symptoms, and, additionally, in children a maternal, neonatal, nutritional and developmental history. For patients with more marked elevations in ALT (>1000 U/L) other possible causes of viral hepatitis should be considered, including hepatitis A and E and cytomegalovirus. Examinations should include: body mass index and an abdominal examina- tion looking for hepatosplenomegaly, ascites and other signs of chronic liver disease. PSC should be considered for patients with raised cholestatic liver enzymes

2017 British Society of Gastroenterology

97. Frailty in Older Adults - Early Identification and Management

for Seniors Clinical Care Management Guideline: 48/6 Model of Care, available at the BC Patient Safety and Quality Council website at: Key Recommendations See . Early identification and management of patients with frailty or vulnerable to frailty provides an opportunity to suggest appropriate preventive and rehabilitative actions (e.g. exercise program, review of diet and nutrition, medication review) to be taken to slow, prevent, or even reverse decline associated with frailty. Use a diligent case (...) and its severity is a better indicator of health status than chronological age. Risk factors for frailty include: advanced age polypharmacy functional decline poverty and/or isolation poor nutrition and/or weight loss medical and/or psychiatric comorbidity Frailty risk and its severity increases with deficit accumulation. 9 Physiological reserve may be further decreased by factors such as exacerbation of chronic disease, acute illness, injury, hospitalization, or a change in social supports, leading

2017 Clinical Practice Guidelines and Protocols in British Columbia

98. CKD-Mineral and Bone Disorders (CKD-MBD)

, such as hyperphosphataemia, hypocalcaemia, and ‘nutritional’ vitamin D deficiency. Treatment of these factors may reduce Final Draft 14 PTH levels toward the reference range, or prevent further increases. Serum alkaline phosphatase may also provide useful information on bone turnover and response to therapy. If PTH levels increase progressively and remain higher than the reference range, treatment with active vitamin D is likely to be necessary. In the dialysis population, the PTH target focuses on avoidance of risk

2015 Renal Association

99. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock

(the Italian Association of Anesthesia and Intensive Care). Dr. Nishida participates in The Japanese Society of Intensive Care Medicine (vice chairman of the executive boards), the Japanese Guidelines for the Management of Sepsis and Septic Shock 2016 (chairman), The Japanese Guidelines for Nutrition Support Therapy in the Adult and Pediatric Critically Ill Patients (board), The Japanese Guidelines for the Management of Acute Kidney Injury 2016 (board), The Expert Consensus of the Early Rehabilitation

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2016 European Respiratory Society

100. Planning, initiation & withdrawal of Renal Replacement Therapy

12 months(4). - 14 - There are many studies albeit of variable quality and generally of small numbers, which have shown that a dedicated pre-dialysis (or =low clearance‘) clinic is associated with improved outcomes and reduced urgent initiation of dialysis (5-8). These clinics should address the complications of progressive CKD such as renal bone disease, nutritional problems and anaemia while still trying to preserve renal function by tight blood pressure control and other measures. Some (...) in a controlled manner, without the need for hospital admission and using an established access ( arteriovenous fistula [AVF], arteriovenous graft [AVG], PD catheter) or by pre-emptive renal transplantation (1B) 5.2 We recommend that the decision to start RRT in patients with CKD stage 5 (eGFR < 15ml/min/1.73m 2 ) should be based on a careful discussion with the patient of the risks and benefits of RRT taking into account the patient‘s symptoms and signs of renal failure, nutritional status, co- morbidity

2014 Renal Association

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